Vaccinating the Underclass

If we want to minimise the impact of the Covid virus we are going to have to think about social class.

New Zealanders do not easily talk about social class: that there are groups in the community who connect together, live different lives and have standards of living very different from the average – who are different from, but still a part of, us. We may recognise such groups exist, but we generally avoid using the notion or incorporate it into our social thinking. (A bit like Victorians being chary of talking about sex.)

Once we would say that New Zealand was a ‘classless society’ or, more cautiously, that we were the least class-bound society in the world. We may have been but the data suggests this is no longer true if it ever was. Often all we meant was to compare ourselves with the English but they are hardly a useful benchmark in the whole world.

We have a curious dialogue which implicitly equates Māori with the lower classes, drawing attention to their low incomes, their poverty, their unemployment, their poor health, housing and life prospects and their high incarceration rates. All true on average, but demeaning to many Māori, who have good jobs, decent incomes, reasonable health, their own homes and high social status and who are proud of their culture. It is true there are proportionally fewer of them than for Pakeha, but it is also true that there are many more Pakeha in total who are low in the socioeconomic rankings.

Covid forces us to face up to the disconnected. A lot of the public dialogue is about Māori who are not vaccinated but there are more non-Māori who are not. On Sunday 17 October we had to vaccinate another 216,000 New Zealanders to meet the 90 percent first-dose target, but there were only 194,000 unvaccinated Māori. Vaccinate every one of them and we would still be short. (This data refers to first-dosed only. Currently, only 66 percent have both.)

However the 90 percent target is not a magical threshold above which all difficulties disappear. It still leaves another 421,000 unvaccinated (plus 216,000 equals 637,000 in total); we need to get to as many of them as possible. The vaccines are not totally effective even though they reduce substantially [Note to Sub: please underline ‘substantially’] the chance of getting the virus, substantially the chance of transmitting the virus and substantially the chance of suffering serious health effects (including death) from the virus. [Note from Sub: I added the latter ‘substantially’s] That means that if we have any residual unvaccinated group, we are all still vulnerable (but much less so than if we were not vaccinated).

Who are in this residual group? We know that they are generally younger than average. The rates of the vaccinated are high among the older groups (including Māori), but begin falling off below the age of 50 and are disappointingly low for the under 35s. We have data for four ethnic groups. Three – Asian, Pasifika and Pakeha – are much the same. But the Māori young are below the youth average, dragging down their ethnic average.

We don’t have class data – its indicators are rarely collected – but from what we do know, the vaccination rates are low in the underclass (not just gangs). We cannot ignore them or we end up with a significant residual among whom the virus can mutate and spread to the rest of the population.

The underclass is less connected with society as a whole and so we have to think about how to vaccinate them differently. Strategies which treat them as middle-class, middle-aged adults are not going to work. Re(re)ad Rosie Scott’s novel Glory Days about the Auckland underclass and ask yourself how the vaccination drive connects with them. (Hospital Emergency Departments should be offering vaccines; that’s a point where the underclass connect with the system.)

We have to abandon the conspiracy of silence about class. ‘Connection’ is probably crucial. Both the Asian and Pasifika communities are doing well with their young – better than Māori or even Pakeha. Allow me to speculate.

Pasifika families are generally strong and often deeply involved with their church. The churches have been at the forefront of vaccination drives including connecting with their young, despite some of their church gatherings having been superspreader events.

Asians are a very heterogeneous group. But again the vaccination rates are high among their young. It may partly be that some Asian countries were badly hit by the SARS epidemic and those Asians are more prepared for Covid. I am also struck by how cohesive many Chinese families are. Perhaps like the Pasifika, they are much better connected with their young. (That may also be true for Indians and South East Asians but does not apply, of course, to overseas Asian students.)

Yes, there are a lot of cohesive Māori and Pakeha families. But there are many who are not; the least cohesive are among the underclass. There is the challenge.

The Māori community may not articulate their challenge in quite this way, but when they say they need registers to run their campaign they are implicitly saying they have lost connections. And yes, they may need to approach their communities differently from the conventional middle-class middle-age Pakeha approach (which may or may not also apply for all the working class either). All power to Māori: kia kaha!

The Vaxathon was targeting groups who are disconnected from middle (older) New Zealanders. Instructively, while about 30 percent of Māori are not vaccinated, only 16 percent of those vaxathonated were Māori, indicative of just how harder it is to deal with the particularities of the unvaccinated rump.

Sure, there are the vaccine deniers, but their number are minor compared to the disconnected. Since the underclass are different, we need to pursue them differently because we need to keep the residual unvaccinated group to an absolute minimum in a post-elimination Covid age.

And when we have got them all, we can lapse back to a public discourse which ignores class.

Footnote: Vaccine deniers are inconsistent when they use the same medical science on which the vaccines are based for their other health purposes. This is nicely illustrated by an Arkansas hospital faced with an unusually high number of employees declaring they could not get the vaccine because of religious convictions that would not allow them to use anything created from fetal cell lines in the development and testing. The hospital informed its employees that they could be granted the religious exemption if they signed a paper attesting that they did not use, and would not use, any of the 30 commercially available products that also used fetal cell lines. They included Paracetamol, Pepto Bismol, Aspirin, Tums, Ibuprofen, Ex-lax, Benadryl, Sudafed, the MMR vaccine, Sertraline, Omeprazole and Azithromycin. The number of those claiming religious exemptions declined drastically.